Translateral Orbital Wall Approach to the Orbit and Cavernous Sinus: Anatomic Study

Area of Science:

• Neurosurgery
• Ophthalmology
• Anatomy

Background:

• Surgical access to the orbit and cavernous sinus is well-established.
• Simultaneous lesions in both the orbit and cavernous sinus present significant surgical challenges.

Purpose of the Study:

• To investigate the microsurgical and endoscopic anatomy of the orbit and cavernous sinus.
• To evaluate the orbitozygomatic and translateral orbital wall approaches for accessing these regions.

Main Methods:

• Dissection of seven formalin-fixed adult cadaveric heads.
• Examination using surgical microscopy and a 0° endoscope.

Main Results:

• The orbitozygomatic approach provides broad exposure of the orbit, optic canal, superior orbital fissure, and cavernous sinus.
• The translateral orbital wall approach offers access to the orbit, optic canal, and superior orbital fissure, extendable to the cavernous sinus, though the corridor is narrow.
• Endoscopic assistance enhances visualization, particularly around the anterior clinoid process and V3.

Conclusions:

• The translateral orbital wall approach, augmented by endoscopy, is a suitable alternative to the orbitozygomatic approach.
• This technique is advantageous for biopsies of unresectable lesions and removal of small lesions in the lateral orbit and cavernous sinus.